Anesthesia management in performing interventional procedures / 介入放射学杂志

ABSTRACT

Objective To describe the importance of anesthesia management in performing interventional procedures. Methods A total of 24 382 patients, who were admitted to authors’ hospital during the period from April 2011 to April 2015 to receive level Ⅲ or level Ⅳ interventional procedures, were enrolled in this study. According to the anesthesia method, the patients were divided into (1) mechanical ventilation group (group A), i.e. intravenous general anesthesia combined with laryngeal mask or endotracheal intubation, (2) intravenous general anesthesia and autonomous respiratory group (group B), (3) conscious sedation group (group C) and (4) local anesthesia group (group D). The heart rate (HR), mean arterial pressure (ABP), blood oxygen saturation (SpO2) and anesthesia-related complications of the patients of all four groups were kept under close observation before, during and after the interventional procedures, the results were statistically analyzed. Results The anesthesia was successfully implemented according to the operation plan in all 24 382 patients. Interventional procedure of level Ⅲ was performed in 16 702 patients(68.5%) and interventional procedure of levelⅣwas adopted in 7 680 patients (31.5%). The patients receiving interventional procedure of level Ⅲof group A, B, C and D were 6 797 (40.7%), 3 608 (21.6%), 5 095(30.5%) and 1 202(7.2%) respectively;while the patients receiving interventional procedure of level Ⅳ of group A, B, C and D were 4 193 (54.6%), 2 527 (32.9%), 699 (9.1%) and 261 (3.4%)respectively. No statistically significant differences in preoperative HR, ABP and SpO2 existed between each other among the four groups (P>0.05). In group A, B and C the HR and ABP values determined in operation were not statistically different from the preoperative ones(P>0.05), and the differences in HR and ABP values among the three groups were also not statistically different (P>0.05);SpO2 levels showed no obvious changes (P>0.05). In group D, the HR and ABP values determined in operation were significantly higher than the preoperative ones (P0.05). In 22 patients of group D the operation had to be stopped as they were unable to tolerate the procedure. Conclusion In performing different levels of interventional procedures, level Ⅲ and level Ⅳ intervention surgeries in particular, careful selection of individualized anesthesia plan on the base of patient’s condition and operation requirement is an important guarantee for ensuring a safe operation with no interference, and it is also a good way to reduce the pain severity of patient. Therefore, individualized anesthesia plan is worth to be widely used in interventional procedures.